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General NPI Number Information
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NPI Number | 1710493374
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Entity Type | Individual
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Provider Name | CHRISTOPHER MICHAEL BIBRO CRNA
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Gender | Male
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Dates
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Enumeration Date | 12/19/2017
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Last Update Date | 12/19/2017
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Provider Practice Location Address
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Address Line | 525 E MARKET ST STE 1E
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City | AKRON
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State | OH
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Zip | 44304-1619
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Country | US
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Telephone | 330-375-3765
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Fax |
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Provider Business Mailing Address
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Address Line | 4857 GRANGER RD
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City | AKRON
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State | OH
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Zip | 44333-1315
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Country | US
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Telephone | 971-678-4189
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | LE-00021798
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License Number State | OH
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